Paralysis obstétricale of the plexus brachial

The paralysis obstétricale of the plexus brachial is a complication of the Accouchement and more particularly of the period of expulsion. It is often an after-effect of the Dystocie of the shoulders but can also occur without dystocie of the shoulders.

It is about a paralysis partial or total of the arm and hand, caused with the birth by a lesion of the nerves located at the root of the secondary arm to a stretching of the Plexus brachial. The arm reached is generally the former arm of the Présentation i.e. that which is presented front at the time of expulsion. There exist also some cases of attacks of the posterior arm

The paralysis being unilateral, the diagnosis is often obvious with the birth: the newborn remains with an arm without movement with another arm animated without a difficult context of childbirth. In approximately 1% of the cases, the paralysis is bilateral

There exist two great types of paralysis: partial paralysis " haute" reaching the shoulder and the elbow total paralysis (20 to 30%) of the cases with paralysis of the hand

It is necessary to seek the complications and signs of gravity such as - the fractures (clavicle, humérus) - paralysis of the phrenic nerve - the sign of Claude Bernard Horner (closed eye on the side reached) often associated with a paralysis of the hand

An assessment of the nerves reached will be made approximately a month after the birth with for example of the complementary examinations in particular the electromyogram.

In the first days, it is very difficult to forecast the possible level of recovery. Spontaneous recovery is possible and depends on the nature of the lesions.

if spontaneous recovery is not significant at the end of one month, it is probable that the child will preserve after-effects An intervention of nervous surgery is possible as of the three months age

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